Social and Economic Outcomes: Are Supported Employment

Home , Supported employment

SOCIAL AND ECONOMIC OUTCOMES:

ARE SUPPORTED EMPLOYMENT SERVICES

FOR INDIVIDUALS

WITH DEVELOPMENTAL DISABILITIES A

GOOD INVESTMENT?

A Review of the Literature

Prepared by the Center for Inclusion and Citizenship

2080 West Mall, The University of British Columbia

Vancouver, B.C. V6T 1Z2 March 2011

This review was prepared by the Center for Inclusion and Citizenship based at the School of Social Work and Family Studies, University of British Columbia. This document is part of a larger project exploring the social and economic outcomes of supported employment for adults with intellectual disabilities.

Research Team: Dr. Rachelle Hole, Professor Tim Stainton- University of British Columbia; Jamie Tomlinson- Registered Social Worker, MSW Student

This research is being supported by Community Living British Columbia

Preface

This report was prepared by the Center for Inclusion and Citizenship and involved a literature search using electronic academic databases (ie. EBSCOhost, Social Service Abstracts) and google scholar. The following search terms were used: “developmental disabilit*”,

“intellectual disabilit*”, “learning disabilit*”, “supported employment”, “open employment”,

“supported employees”, “vocational rehabilitation”, “employment supports”, and “employment programs”. The authors included literature from Canada, The United States, Europe, Australia, and New Zealand.

The purpose of this report is to provide an overview of the literature to date on the social and economic outcomes of supported employment for adults with intellectual disabilities. The academic literature, selected program initiatives on supported employment, and policy reports on supported employment have been explored in this document. It should be noted that the research on policy and program initiatives is in the preliminary phase. Therefore, the information contained in the summary on these topics is meant to highlight examples of supported employment initiatives and reports, and is not meant to be exhaustive.

Key Terms Defined

This section provides general definitions for terms used in this report.

Supported Employment

Community Living British Columbia defines supported employment as real work in an integrated setting with on-going support provided by a knowledgeable service provider with expertise in finding employment for people with developmental disabilities.

Sheltered Employment

Also referred to as day programs, sheltered employment involves employment-related activities in a protective, segregated environment.

Introduction

This report reviews the literature on the social and economic outcomes of supported employment for adults with intellectual disabilities. Research is reviewed from The United

States, Australia, New Zealand, and The United Kingdom. The authors sought to include

Canadian research when possible and relevant, although the Canadian literature on this topic was scarce. The outcomes of particular interest to the researchers included cost-efficiency to the taxpayer, economic benefits to the employee and employer, and social opportunities for the consumer when engaging in supported employment. The disadvantages of sheltered employment and day programs for adults with intellectual disabilities are also discussed.

Historically, day programs were the only opportunity that adults with intellectual disabilities had for engaging in employment. However, progress in the community living movement that promotes self-determination and rights for people with disabilities has created more diverse and inclusive employment opportunities.

This review begins by offering a brief overview of the sheltered and supported employment approaches for adults with intellectual disabilities. In doing this, the writers hope to highlight the advantages of supported employment, and the limitations of sheltered employment and day programs. Next, the findings of a systematic literature review on the social and economic outcomes of supported employment are presented. The report concludes with a brief discussion on the challenges of implementing supported employment initiatives, and offers

4 recommendations on how to promote inclusive and diverse employment options for adults with intellectual disabilities. Overall, the primary purpose of the review is to determine whether or not supported employment is a good investment for employers, tax payers, and supported employees.

Sheltered Models of Employment

While the progression of the community living movement has increased employment opportunities, many adults with intellectual disabilities continue to be excluded from meaningful employment opportunities, and are resigned to work in sheltered employment and day programs.

Although these programs offer opportunities for participation in some vocational activities, consumers are often not paid meaningful wages when compared to mainstream employment opportunities. Sheltered employment and day programs also consist of a segregated work environment in which adults with intellectual disabilities are given no opportunities to socialize outside of disability networks. By excluding people from meaningful employment opportunities, the notion that adults with disabilities are unable to contribute to their community is reinforced.

Further, consumers often do not have a choice in employment activities, but rather are assigned tasks based on the mandate of the day programs. This not only prevents adults with intellectual disabilities from partaking in meaningful employment, but also restricts opportunities for learning and practicing employment skills.

The segregated nature of sheltered employment programs has negative implications for the socioeconomic well-being of adults with intellectual disabilities. Research indicates that people in sheltered employment programs experience lower self-esteem and job satisfaction when compared to participants in supported employment. The lack of opportunities offered by

5 sheltered workshops not only decreases autonomy, but also prevents many people from reaching their maximum potential, and achieving meaningful vocational goals. Lastly, the limited opportunity for meaningful wages increases the likelihood of poverty and dependence on public funding for adults with intellectual disabilities.

Supported Employment

Unlike sheltered employment, supported employment for adults with intellectual disabilities involves work in an integrated setting with ongoing support provided by an agency designated to support adults with disabilities (Canadian Association for Supported Employment,

2007). Research indicates that many individuals with intellectual disabilities aspire to engage in supported employment over sheltered or segregated employment. Work within the community is not only a vital step in inclusion, but is also associated with an increase in social and economic well-being for adults with intellectual disabilities (Jahoda, Kemp, Riddell, & Banks, 2008; Kober

& Eggleton, 2005; Schur, 2002). Despite the benefits of supported employment, many adults with intellectual disabilities are only given opportunities to work within day programs that do not offer a chance for meaningful employment or equal social and economic opportunities. Cimera

(2009b) notes that there are still a large number of adults with intellectual disabilities who are placed in segregated employment arrangements. Further, sheltered employment and day programs continue to receive more funding than supported employment, despite the benefits to the stakeholder and the taxpayer. In order to overcome this issue, it is important that researchers, service providers, and policy makers work collaboratively to increase opportunities for supported employment. Therefore, this report is intended to promote more inclusive work environments by highlighting the social and economic benefits that supported employment has for employees, employers, and the taxpayers.

Literature Review

As stated above, this research on the outcomes of supported employment focuses on three areas: the social benefits to the employee, the economic benefits to the employer and taxpayers, and the economic benefits to the employee. Quantitative methods were generally used in the studies, and the research is predominantly from the United States, Australia, and the United

Kingdom. The studies are heavily weighted on the social outcomes, and economic advantages to the employer; however, research on the economic benefit to the employee remains scarce.

Social Outcomes

This section highlights the social outcomes of supported employment for adults with intellectual disabilities. Several studies have been conducted that investigate the social outcomes of supported employment for adults with intellectual disabilities. Research on the social outcomes generally recognizes the social benefits of supported employment for adults with intellectual disabilities. The literature examined reveals that supported employment is associated with an increase in social status, social inclusion, and social skills (Flores et al, 2011; Jahoda et al., 2008; Jahoda et al., 2009; Kober & Eggleton, 2005). This often leads to a higher level of perceived job satisfaction, and more opportunities for community interaction. Supported employment has also been revealed as a viable way for adults with intellectual disabilities to socialize with people who are not associated with disability services (Forrester-Jones et al.,

2004). Forrester-Jones’ study (2004) also indicates that supported employment creates more opportunities for adults with intellectual disabilities to engage in leisure activities more frequently than those who are engaged in sheltered employment or day programs. Schur (2002) indicates that employment reduces social isolation, and can teach people skills that increase community and political participation. Supported employment is also associated with a higher

7 quality of life, mental health, and self esteem when compared to sheltered employment and day programs (Flores et al., 2001; Forrester-Jones et al., 2004; Kober & Eggleton, 2005). This is attributed to the greater perceived satisfaction with social, leisure, and personal opportunities that supported employment has to offer. In summation, supported employment opportunities for adults with intellectual disabilities is a viable way to create inclusive communities in that it offers chances for social networking and interactions outside of the disability community.

Economic Costs & Benefits

The costs and benefits of supported employment for adults with intellectual disabilities to employers and taxpayers have been examined by scholars in vocational rehabilitation, disability and healthcare policy, and disability practice. The research consistently demonstrates that the long term costs of supported employment decrease over time, whereas sheltered employment or day programs tend to increase or remain constant (Cimera, 2008; Cimera, 2009a; Cimera 2009b;

Shearn, Beyer, & Felce, 2000; Tuckerman, Smith, & Borland, 1999). A pilot study further determines that adults with intellectual disabilities in supported employment arrangements have an employment retention rate that was three times higher than other employees (Cimera, 2009a).

This finding suggests that the high retention rate of supported employees could save employers expenses associated with hiring and training new employees. Cimera’s study (2009a) also proposes that supported employees produce greater net benefits to the employers when compared to non-disabled employees. Further, employers are often offered tax credits, government wage subsidies, and other financial incentives that make supported employment a beneficial option for employers. Lastly, Cimera (2009a) concludes that supported employees incur less supervisory costs than non-disabled employees; he infers that this could allow employers to reallocate or save money that is designated to supervise employees. However, it should be noted that the sample

8 size in this study was too small to draw definitive conclusions. A previous study by Cimera

(2008) also concludes that supported employment in the United States is a better long term investment for taxpayers. A follow up study by Cimera (2009b) demonstrated that for every tax dollar garnered by taxpayers for supported employment, they receive $1.46 in benefits. This equated to an approximate net benefit of $251.34 to the taxpayers. In summation, research suggests that hiring adults with intellectual disabilities as supported employees generates positive economic outcomes for both employers and taxpayers.

Economic Benefits to Employees

Research suggests that supported employees make up to three times as much as sheltered employees. Two studies have been reviewed that address the economic impact of supported employment for adults with intellectual disabilities. Schur (2002) conducted a twelve month study in the United Kingdom to explore the effects of supported employment on earnings, benefits, and tax allowances claimed. The findings from the study reveal that employment for adults with intellectual disabilities is estimated to raise household income by 49%. Further, adults who participate in supported employment initiatives are less likely to live in poverty, or be reliant on public services for financial support. Schur’s (2002) findings indicate that employment lowers the poverty rate by 20 percent points among adults with disabilities. A study on gender differences supports these findings, adding that women with intellectual disabilities work in lower wage jobs and earn less money annually (Boeltzig, Timmons, & Butterworth,

2009). The study further suggests that while both men and women with intellectual disabilities are making meaningful wages when compared to disability benefits, women are offered fewer opportunities to engage in fulltime employment. Therefore, it is important that service providers

9 and policy makers alike focus on creating equal employment opportunities for women with intellectual disabilities.

Conclusions & Future Directions

With the recent shifts in the community living movement that promote inclusion and self- determination, employment opportunities that reflect choice and diversity for adults with intellectual disabilities are receiving growing support. This has prompted service providers and policy makers to examine the benefits of supported employment, and recognize the limitations of day programs and sheltered employment. Researchers have explored both the social and economic advantages of supported employment, and have highlighted many positive outcomes associated with this approach. The social outcomes included: increased social networks, greater sense of social status, social inclusion, and social involvement. The economic outcomes included: benefits for taxpayers, financial advantages for employers, and greater financial security for adults with intellectual disabilities.

However, while the benefits of supported employment far outweigh those of sheltered employment and day programs, it is important to recognize the limitations of this approach. For example, while supported employment allows for more opportunities for community integration and socialization, the social benefits did not equate to a greater sense of belonging or reciprocal relationships. Consequently, many supported employees did not perceive their friendships with co-workers and community members to extend beyond the workplace. Therefore, it is important that employment service providers and workplaces alike do not reinforce the marginalized social status of adults with intellectual disabilities. Another challenge of promoting supported employment lies within the lack of potential employer’s knowledge on the advantages and

10 positive outcomes of hiring supported employees. Therefore, service providers and policy makers need to educate employers on the cost-effectiveness of hiring supported employees, and the social benefits experienced by the consumers. In doing this, we are not only creating better opportunities for employment, but also more inclusive communities for adults with intellectual disabilities.

References

Canadian Association for Supported Employment. (2007). Supported employment. Retrieved March

16, 2011, from http://supportedemployment.ca/en/index.html

Cimera, R. (2008).Cost trends of supported employment versus sheltered employment. Journal of

Vocational Rehabilitation, 28, 15-29.

Cimera, R. (2009). The monetary benefits & costs of hiring supported employees: A pilot study.

Journal of Vocational Rehabilitation, 30, 111-119.

Cimera, R. (2009) Supported employment’s cost efficiency to tax payers: 2002-2007. Research and

Practice for Persons with Severe Disabilities, 34(2), 13-20.

Creswell, J. (2007). Qualitative inquiry & research design: Choosing among the five approaches.

California: Sage Publications.

Flores, N., Jenaro, C., Orgaz,B.M., & Martín, M. (2011). Understanding quality of working life of

workers with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 24

(2), 133-141.

Forrester-Jones, R., Jones, S., Heason, S., & Di’Terlizzi, M. (2004). Supported employment: A route to

social networks. Journal of Applied Research in Intellectual Disabilities, 17, 199-208.

Grant, B., & Giddings, L. (2002). Making sense of methodologies: A paradigm framework for the

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Greenhalgh, T. (2010). How to read a paper: The basics of evidence-based medicine (4th Ed.). Highgate

Hill, London: Blackwell Publishing.

Jahoda, A., Kemp, J., Riddell, S., & Banks, P. (2008). Feelings about work: A review of the socio-

emotional impact of supported employment on people with intellectual disabilities. Journal of

Applied Research in Intellectual Disabilities, 21, 1-18.

Jahoda, A., Banks, P., Dagnan, D., Kemp, J., Ken, W., & Williams, V. (2009). Starting a new job: The

social and emotional experience of people with intellectual disabilities.

Kober, R., & Eggleton, I.R.C. (2005). The effects of different types of employment on quality of life.

Journal of Intellectual Disability Research, 49 (10), 756-760.

Mason, J. (2002). Qualitative researching (2nd ed.). Thousand Oaks, CA: Sage Publications.

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Seamon, D. (2002). Phenomenology, place, environment, and architecture: A review of the literature.

Alberta: Max Van Manen.

Shearn J., Beyer S. & Felce D. (2000). The cost-effectiveness of supported employment for people with

severe intellectual disabilities and high support needs: a pilot study. Journal of Applied Research

in Intellectual Disabilities 13, 29–37.

Starks, H., & Brown -Trinidad, S. (2007). Chose your method: A comparison of phenomenology,

discourse analysis, and grounded theory. Qualitative Health Research, 17, 1372-1382.

Tuckerman, P., Smith, R., & Borland, J. (1999). The relative cost of employment for people with a

significant intellectual experience: The Australia experience. Journal of Vocational

Rehabilitation, 13, 109-116.

Verdugo, M.A., de Umes, F.B., Jenaro, C., Caballo, C., & Crespo, M. (2006). Quality of life of

workers with an intellectual disability in supported employment. Journal of Applied Research in

Intellectual Disabilities, 19, 309-316.

Verdugo, M.A., Martin,-Ingelmo, R., Jordan de Urries, F.B., Vincent, C., & Sanchez, M.C.

(2009).Impact on quality of life and self-determination of a national program for increasing

supported employment in Europe. Journal of Vocational Rehabilitation, 31, 55-64.

APPENDIX I: THEMATICALLY GROUPED LITERATURE

Social Outcomes of Supported Employment for Adults with Intellectual Disabilities

Flores, N., Jenaro, C., Orgaz,B.M., & Martín, M. (2011). Understanding quality of working life of workers with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 24 (2), 133-141.

This paper examines the perceived quality of working life of workers with intellectual disabilities. Specifically, this paper looks at participants' perceptions in relation to perceived job demands and resources and their impact on experienced job satisfaction. In this cross-sectional survey, 507 workers with intellectual disabilities, employed in either sheltered workshops or supported employment, completed questionnaires on the quality of working life through semi- structured interviews. Regression analyses showed that perceived low job demands and elevated social support from coworkers and supervisors predicted higher quality of working life. Common organizational psychology measures can be successfully used with this population to assess quality of working life. This study confirms the multidimensional nature of quality of working life, and the impact of job demands and available resources on perceived satisfaction with job for workers with intellectual disabilities. Although this article focuses on factors in the workplace that either contribute or impede quality of life for individuals with intellectual disabilities, it recognizes that meaningful employment increases social status, social inclusion, and quality of life.

Forrester-Jones, R., Jones, S., Heason, S., & Di’Terlizzi, M. (2004). Supported employment: A route to social networks. Journal of Applied Research in Intellectual Disabilities, 17, 199-208.

Evidence suggests that social networks mediate social functioning, self-esteem, mental health and quality of life. This paper presents findings concerning changes in the social lives, skills, behaviors, and life experiences of a group of people with intellectual disabilities who gained support from an employment agency to find paid work.

Jahoda, A., Kemp, J., Riddell, S., & Banks, P. (2008). Feelings about work: A review of the socio-emotional impact of supported employment on people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 21, 1-18.

Work is an aspiration for many people with intellectual disability and is regarded as a vital goal by policy-makers in pursuit of social inclusion. The aim of this study was to consider the impact of supported employment on the socio-emotional well-being of people with intellectual disabilities. Method A systematic search was conducted. The review included case-controlled and longitudinal studies measuring outcomes for: quality of life, social life and autonomy. While

15 results for quality of life, well-being and autonomy were largely positive, there was a lack of perceived social acceptance. The findings are interpreted in the light of methodological strengths and weaknesses. Implications for the socio-emotional support required by some individuals in employment, and directions for future research are also discussed.

Jahoda, A., Banks, P., Dagnan, D., Kemp, J., Ken, W., & Williams, V. (2009). Starting a new job: The social and emotional experience of people with intellectual disabilities.

Employment is viewed by policy makers as both a human right and as a means of changing the marginalized status of people with intellectual disabilities, with important social and emotional benefits. However, there has been little longitudinal research examining the experience of people with intellectual disabilities in the workplace. Thirty-five individuals with mild to borderline intellectual disabilities participated in this study. They were recruited from supported employment agencies in Scotland. A longitudinal approach was adopted, with the participants being interviewed around the time of starting their jobs, and again 9–12 months later. The content analyses of the semi-structured interviews indicated that the participants perceived continuing benefits from entering mainstream employment, including more purposeful lives and increased social status. However, over the follow-up period the participants reported few social opportunities that extended beyond the workplace, and an anxiety about their competence to meet employers’ demands remained a concern for some. Conclusions: The discussion addresses the importance of understanding work in relation to the participants’ wider lives, along with the longer-term role for supported employment agencies to help people achieve their social and emotional goals in a vocational context.

Kober, R., & Eggleton, I.R.C. (2005). The effects of different types of employment on quality of life. Journal of Intellectual Disability Research, 49 (10), 756-760.

Despite research that has investigated whether the financial benefits of open employment exceed the costs, there has been scant research as to the effect sheltered and open employment have upon the quality of life of participants. The importance of this research is threefold: it investigates outcomes explicitly in terms of quality of life; the sample size is comparatively large; and it uses an established and validated questionnaire.

Verdugo, M.A., de Umes, F.B., Jenaro, C., Caballo, C., & Crespo, M. (2006). Quality of life of workers with an intellectual disability in supported employment. Journal of Applied Research in Intellectual Disabilities, 19, 309-316.

This study investigates what characteristics of supported employment increase quality of life and whether quality of life is higher in supported employment workers or the sheltered ones in Spain. Typicalness, the degree to which the characteristics of a job are the same as those of co- workers without a disability in the same company, was considered as one of the supported

16 employment characteristics in the analysis. Two groups were put together to obtain the data using two questionnaires that were administered by trained professionals. Results No differences were found between the two groups regarding quality of life but results indicate that in supported employment, high levels of typicalness are associated with a higher quality of life and that the handling of certain characteristics of support and the job are related to the enhancement of quality of life of the workers. Workers in supported employment show the same quality of life as those in sheltered employment centers. In Spain, the greater the typicalness of the employment, the higher the quality of life. The implications of this for the amount of direct external support for workers with disability is that such support should be used only when absolutely necessary – the minimum support necessary to encourage development.

Economic Outcomes of Supported Employment for Adults with Intellectual Disabilities

Cost and Benefits of Supported Employment

Cimera, R. (2008).Cost trends of supported employment versus sheltered employment. Journal of Vocational Rehabilitation, 28, 15-29.

This study investigated the cost-trends of supported and sheltered employees with mental retardation as they completed one "employment cycle" (i.e., from the point they entered their programs to the point when they changed their jobs, left their program, or otherwise stopped receiving services). Data indicate that the cumulative costs generated by supported employees are much lower than the cumulative costs generated by sheltered employees ($6,618 versus $19,388). Further the cost-trend of supported employees was downward while the cost-trend of sheltered employees was slightly upward, indicating that the costs of supported employment decline over time while those of sheltered workshops increase.

Cimera, R. (2009). The monetary benefits & costs of hiring supported employees: A pilot study. Journal of Vocational Rehabilitation, 30, 111-119.

This paper illustrates the implementation of a new cost-accounting methodology that can be used to measure the monetary outcomes of supported employment from the perspective of employers. The methodology attempts to ascertain which "type" of employee (i.e., workers with disabilities versus workers without disabilities) is most economical for employers to hire. Avenues for future research are also presented.

Cimera, R. (2009). The national costs of supported employment to vocational rehabilitation: 2002 to 2006. Journal of Vocational Rehabilitation, 30, 1-9.

This study investigated the costs accrued by all supported employees funded by Vocational Rehabilitation from 2002 to 2006 throughout the entire United States and its territories. Costs were examined in relation to the number of hours supported employees worked, and total wages that they earned, per week. The impact of disability, presence of secondary disabilities, the supported employee's level of education and employment history were also examined.

Cimera, R. (2009) Supported employment’s cost efficiency to tax payers: 2002-2007. Research and Practice for Persons with Severe Disabilities, 34(2), 13-20.

This study explored the cost-efficiency of all 231,204 supported employees funded by vocational rehabilitation throughout the entire United States from 2002 to 2007. Results found that supported employees returned an average monthly net benefit to taxpayers of $251.34 (i.e., an annual net benefit of $3,016.08 per supported employee) and generated a benefit-cost ratio of 1.46. Further, economic returns of supported employees were investigated across nine disabling conditions. Even individuals with the least cost-efficient disability (i.e., traumatic brain injuries) returned to taxpayers a monthly net benefit of $111.62. Finally, this study determined that supported employees with multiple conditions were as cost-efficient as individuals with only one disability (i.e., benefit-cost ratios of 1.49 versus 1.46, respectively).

Farris B., & Stancliffe R. (2001). The co-worker training model: outcomes of an open employment pilot project. Journal of Intellectual & Developmental Disability, 26, 145–161.

This pilot study evaluated the viability of trained co-workers providing direct job training and support to employees with a disability in open employment. Selected staff from 11 KFC restaurants attended a 2 day co-worker training course. Following training they placed a modestly but significantly higher value on persons with a disability in the workplace than previously. Subsequently, an individual with a disability was employed in each of 10 KFC restaurants and received job training and support from a co-worker trainer. Employment outcomes for consumers with co-worker support were as good as for a comparison group who worked in similar jobs at KFC restaurants with job coach support. Comparison group members received substantially more support hours from job coaches. Consumers with co-worker support experienced high levels of involvement with co-workers. The co-worker training model may provide a viable, cost-effective alternative to the traditional place and train model.

Shearn J., Beyer S. & Felce D. (2000). The cost-effectiveness of supported employment for people with severe intellectual disabilities and high support needs: a pilot study. Journal of Applied Research in Intellectual Disabilities 13, 29–37.

The costs and outcomes of supporting seven people with severe intellectual disabilities and high support needs in part-time employment were compared with those of a Special Needs Unit of a day centre, both within-subject and against an equal-sized comparison group. The

18 income of those employed was described. Direct observation of the employment activities and representative Special Needs Unite activities were undertaken to assess participant engagement in activity and receipt of assistance, social contact in general and social contact from people other than paid staff. Costs of providing service support were calculated taking account of staff: service user ratios, staff identities and wage rates and service-administrative and management overheads. Employment was associated with greater receipt of assistance, higher task-related engagement in activity and more social contact from people other than paid staff. SNU activities were associated with greater receipt of social contact. Supporting people in employment was more expensive than in the Special Needs Unit. Cost-effectiveness ratios of producing assistance and engagement in activities were equivalent across the comparative contexts. The Special Needs Unit was more cost-effective in producing social involvement; employment in producing social contact from people other than paid staff.

Tuckerman, P., Smith, R., & Borland, J. (1999). The relative cost of employment for people with a significant intellectual experience: The Australia experience. Journal of Vocational Rehabilitation, 13, 109-116.

In Australia, adults with a moderate to severe intellectual disability receive a Commonwealth Government Disability Support Pension and may enter Commonwealth Government funded employment programs or State Government funded community activity programs. This paper compares the cost to government of Jobsupport (an open employment program) and the available alternatives. Background data about Jobsupport, including satisfaction surveys of employers and people with disabilities supported by Jobsupport, is included. Comparisons with other options show Jobsupport to be a cost effective option for government and almost revenue neutral per client for the Commonwealth Government compared to the pension after 12 months. This result has been relatively robust over time; as government funding has increased and the program has grown in size, cost per client has remained steady in real terms. In evaluating the cost of the Jobsupport program, displacement effects have proved to be less important than had been previously believed and smaller for Jobsupport than in general labor market programs. Even when displacement differences are included, there are significant savings, including reductions in pension payments, from programs such as Jobsupport. When these savings are considered, a Jobsupport open employment program is much less expensive than State-funded Post School Options activity programs.

Verdugo, M.A., Martin,-Ingelmo, R., Jordan de Urries, F.B., Vincent, C., & Sanchez, M.C. (2009).Impact on quality of life and self-determination of a national program for increasing supported employment in Europe. Journal of Vocational Rehabilitation, 31, 55-64.

Supported employment in many European countries is spreading somewhat slowly, with specific nationwide programs being required to enable significant progress in integrating people

19 with disabilities and other limitations into the ordinary labor market. This article describes the Caja Madrid SE Program, deployed throughout every province in Spain, for people with disabilities and people who experience social exclusion. We set out the characteristics of the program, the profile of those taking part, and the results achieved in terms of employment between 2005 and 2007. Finally, we include the results of the research related to the participants' quality of life and self-determination.

Economic Impact on Adults with Intellectual Disabilities

Boeltzig, H., Timmons, J., & Butterworth, J. (2009).Gender differences in employment outcomes of individuals with developmental disabilities. Journal of Vocational Rehabilitation, 31, 29-38.

The paper presents employment outcomes of men and women with developmental disabilities who recently entered individual employment with the support of a community rehabilitation provider. The findings are based on an analysis of the National Survey of Community Rehabilitation Providers, Individual Employment Outcomes Survey, conducted between 2004 and 2005 by the Institute for Community Inclusion at the University of Massachusetts in Boston. Survey results show that while men and women with developmental disabilities are earning meaningful wages, women with developmental disabilities are working fewer hours in lower-wage jobs and earn less money, although only the latter was found to be statistically significant. Significant gender differences were found, however, with respect to the types of jobs men and women with developmental disabilities held in individual employment. Overall, outcome findings suggest consistency with previous research. The paper concludes with a discussion of the implications of these findings and provides directions for future research.

Schur, L. (2002). The job makes a difference: The effects of employment among people with disabilities. Journal of Economic Issues, 36 (2), 339-348.

A 12-month study of UK supported employment providers found that 77 (54.6%) of the participants in the study remained unemployed, 32 (22.7%) got jobs and 32 (22.7%) retained the jobs they held at the outset. Aims: To explore the impact of moving into employment on service use, earnings, benefits and tax allowances claimed. Methods: Service use and frequency were measured at baseline and 12 months. Comparisons paid particular attention to the differences between people entering work and those who remained unemployed. Costs were analyzed from a government perspective (excluding earnings) and a societal perspective (excluding welfare benefits and taxes). People who entered work reduced their consumption of mental health services. However, use of supported employment increased, in contrast to falling use by people who remained unemployed and those who had been working for more than one year. The increase in earnings for those entering work was not offset by a similar reduction in

20 benefits. Conclusion: This indicates that mental health services may make savings as a result of their clients engaging in paid work. It raises questions about the optimal nature and organization of employment support for this service user group.

Supported Employment Programs & Initiatives

Association for Persons in Supported Employment www.disabled-world.com

APSE is a growing national non-profit membership organization, founded in 1988 as the Association for Persons in Supported Employment, now known as APSE. APSE is a national organization with an exclusive focus on integrated employment and career advancement opportunities for individuals with disabilities. APSE has chapters in 35 states and the District of Columbia.

British Association for Supported Employment www.base-uk.org

The British Association for Supported Employment is the national trade association representing hundreds of agencies involved in securing employment for people with disabilities. The association aims to raise awareness of supported employment, represent the sector on a collective basis, inform members, and encourage best practice. BASE facilitates regional member networks and supports providers and employers by being a hub of information and good practice.

Canadian Association for Supported Employees www.supportedemployment.ca

Established in 1999, CASE was initially an informal network of service providers and concerned citizens who were concerned about the full participation of persons with disabilities in the Canadian labour force. CASE became incorporated in 2003 to reinforce supported employment initiatives throughout Canada. The Canadian Association for Supported Employment is a national association of community-based service providers and stakeholders who are active and invested in Employment for Persons with disabilities. This association strives to promote full citizenship and personal capacity for persons with disabilities through the facilitation of increased labour market participation and outcomes. Through such workforce participation, CASE also promotes social inclusion for Canadians with disabilities.

European Union of Supported Employment

21 www.euse.org

The European Union of Supported Employment (EUSE) was established in 1993 to facilitate the development of Supported Employment throughout Europe. Supported Employment assists people with significant disabilities (physical, intellectual, psychiatric, sensory and hidden) to access real employment opportunities, of their own choice, in an integrated setting with appropriate ongoing support to become economically and socially active in their own communities. EUSE works to achieve this through the promotion of the Supported Employment model, the exchange of information and knowledge on good practice in Supported Employment and the development of model services. EUSE provides a platform for networking with other organizations and associations at European and worldwide level.

Reports

Department of Education, Employment, and Workplace Relations. (2008). The future of disability employment services in Australia. Australia: Author.

European Union of Supported Employment. (2009). Supported employment for key policy makers. Scotland: Author.

Kaplan, G, Hasiuk, E., & Martens, C. (2001). The Manitoba supported employment infrastructure review. Winnipeg: Kaplan & Associates.

O’Bryan, A., Simons, K., Beyer, S., & Grove, B. (2000). A framework for supported employment. United Kingdom: Joseph Rowntree Foundation.